Provider Demographics
NPI:1194295337
Name:JIMENEZ CHINEA RENAL CARE LLC
Entity type:Organization
Organization Name:JIMENEZ CHINEA RENAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ CHINEA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-379-0995
Mailing Address - Street 1:76 REINA DE LAS FLORES
Mailing Address - Street 2:URB ESTANCIAS DE TORRIMAR
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-379-0995
Mailing Address - Fax:
Practice Address - Street 1:87 CALLE JOSE DE DIEGO
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-2415
Practice Address - Country:US
Practice Address - Phone:787-870-2367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21122OtherLIC MD